Every morning when I stepped into my kindergarten pal Nancy's home, her mother would be opening the plastic capsule of a multivitamin tablet and mixing it with her orange juice. Nancy hated milk and would usually kick up a fuss about eating her vegetables. She could live on potatoes. Her mother, a nurse at a local hospital, always feared for her health because of her poor eating habits. I do not know whether that vitamin pill ever did her any good, for Nancy continued to be a sickly child.
‘Shortcut foods'
What seemed a rarity in those days has become the norm now. Take a look around the food courts. Most children survive on a diet of fried chicken nuggets and cola. Talk to their mothers about food and they will tell you how they force a malted nutritional drink down their child's throat every morning and a calcium pill during the day.
They eat a diet that has either too much starch, or too much sugar and excludes other food groups. This is why mothers today feel if their child has had an energy supplement in their milk or food, it compensates for any deficiencies. But is this so? Are these health supplements really the way to compensate for a child's nutritionally deficient diet?
According to Dr Nisha Soares, a specialist paediatrician at Al Zahra Hospital, Sharjah, "The major problem facing most parents as well as paediatricians today is that children eat less home-cooked food and more processed food, the biggest component of the latter being fast food." Blame it on lifestyle or a lack of time to cook, parents start feeding their children with ‘shortcut foods' like fries, cookies and noodles. These foods may taste good but they are unhealthy options. They encourage children to become picky eaters.
"(Picky eating) is a growing problem among children in the age group of one to four," says Dr Soares. "This is because children today eat less home-made food and in a bid to ensure their child's mental agility or physical health does not get affected, parents turn to health supplements and assume that these will meet their nutritional needs."
Picky and strong
Even as many parents introduce health supplements to their child's diet, they are not really aware of the true impact of their decisions. They do not know if the supplements will do their children any good. What's more they perhaps do not ask of themselves if it is too early for their child to be benefiting from health supplements.
According to Dr Soares, the origins of this problem definitely lie in the formative years of a child and the role parents play during this phase.
"Many parents feel the problem (of picky eating) is unique to their child but I would like them to know that this is a problem faced by parents almost everywhere. What makes these years in a child's life a challenge for parents is that children of this age are both stubborn and strong - stubborn enough to refuse to eat for long periods if denied the foods they want, and strong enough to withstand the hunger pangs that follow."
Dr Soares cites the case of a three-year-old who would get by on just two biscuits for the whole day.
"You cannot force-feed children of this age," she says.
"At the same time this is a period when the child's body and bone structure is being strengthened and if a child develops picky eating habits, it's the beginning of a long struggle for parents to correct the dietary imbalances."
In sheer desperation to get a child to eat, Dr Soares says parents often offer the child anything.
"Children being children, faced with a choice will opt for juice, chips, burgers and biscuits, which are tasty but unfortunately not so healthy. So on the one hand while a child appetite improves as he grows older, on the other hand, his food habits are likely to become ingrained. A skinny four year old therefore becomes an obese eight year old. As a result, the child's risk of getting diabetes in his adulthood is trebled."
Overexposure to information is also to blame
Dr Soares has come across several cases where parents have been influenced and swayed by the media which insists that health supplements are a must for children.
To combat and address the issue of eating the wrong foods and then having to correct the imbalance caused by these diets, parents often add health supplements like energy drinks and milk supplements to their child's diet.
"I cannot really blame anyone, including the parents, because there is a serious lack of awareness and a paucity of knowledge on proper nutrition and dietary habits among parents themselves."
In an era of information overload and excessive media exposure, parents get "bombarded by information that suggests supplements will improve their child's immunity and IQ. This is untrue," says Dr Soares.
"The most common health supplements," she says, "are milk additives and vitamins. Parents must understand the concept of the Recommended Daily Allowance (RDA)." Scientists have long since defined the precise and exact amounts of nutrients and micro-nutrients that are necessary for daily functioning, that is the RDA.
Parents, suggests Dr. Soares, must read the nutritional information on the box to know of the amount or percentages of the nutrients being supplied by the company making the product. Often, that amount is too small or insufficient to supplement dietary needs. This is especially true in milk additives where the amount adds up to a negligible percentage of calories needed for the day. Parents must not depend on these to make up a good breakfast.
"However, this is not to say that all supplements are to be disregarded," she says. "There is a well-defined role vitamins, iron supplements and calorie additives play in some naturally picky eaters and pubertal teenagers. These children have growth spurts and the case for iron and calcium supplements to keep up with growth is strong."
Administering vitamin supplements in some cases is warranted. "There have been cases where biosocial conditions predispose groups of pregnant women to a deficiency in Vitamin D and as a consequence, their offspring lack it too. So giving these children Vitamin D as a supplement is called for. Many people are unaware that vitamin D in its natural form helps calcium to be absorbed by the body."
A child's ideal diet
According to Dr Soares, "The ideal diet for a child is the original and culture-based diet of the family. Children should eat what the family is eating. This is because the original cuisines for most countries are well-balanced and contain something from all food groups. For example, you will find rice, lentils and vegetables in most Asian diets; breads, meat and salads in the Arab cuisine; noodles with meat and vegetables in South East Asia and the like. It is when individual portions are askew that the problems begin. This is true in cases where children who have large helpings of rice refuse to eat vegetables; or eat noodles with sausages but say no to vegetables along with it. These kids are at a risk of obesity and are still suffering from malnutrition as they lack iron and vitamins.
"In my clinical experience, I have come across children who have a natural [which is the key word] slowing of growth and consequently very little interest in food."
Healthy children, she says, do not need any additional vitamins or supplements. The administration of health supplements could lead to the start of food likes and dislikes.
If supplements have to be given, please do so under medical supervision, she advises.
Also, "children are prone to developing anaemia by rejecting food containing iron. If you think your child has been looking pale, it may be worth taking him to a doctor".
It also helps when a parent insists that disciplined dietary habits be followed by his child.
"If your child is hungry but does not want to eat home-cooked food, the answer is not to give him fast food. Be more strict and ensure he eats home-cooked food that is healthy."
Her golden principle, "If your child gets stubborn, you get more stubborn After all, a healthy child is not going to starve if in a fit of stubbornness, he refuses lunch and dinner or even both meals. Hungry children will eventually eat.
"And when they do make sure they eat healthy home-cooked food and not something off a table at a fast food joint."
ROLE OF VITAMINS
What exactly is the role of vitamins, calcium etc? Do candy multi-vitamins really work? "Though there is new research available every day, which redefines the roles of vitamins and minerals," says Dr Soares, "in general, the following information should be kept as a benchmark."
- Vitamin A is also known as the vitamin to improve vision. It is especially helpful in maintaining the integrity of the eye and also other organs like the skin and placenta.
- All the B vitamins are responsible for the overall working of enzymes of cells - to the end this helps nerves and the lining of body organs.
- Vitamin C is essential for the formation of collagen. It helps immensely in repairing blood vessels in the case of an injury.
It also helps build strong gums.
- These days, the one vitamin being the ‘most talked about ' is Vitamin D. Better known as the ‘sunshine vitamin', it is important for the growth and well-being of bones and teeth. Vitamin D has recently gained a lot of importance in recent times in its effects in a host of areas ranging from immunity to cancer prevention.
- Calcium is the substrate through which Vitamin D works and the target organs are the same - bones and teeth.
- Fish oils have Omega 3 fatty acids and have gained a lot of interest. Researchers have brought forth studies that go to show that they benefit in developing the brain to improve IQ.
Mum knows best
Dr Soares cannot emphasise these enough:
- The importance of a good breakfast. No health supplement can replace it.
- The benefits of eggs. "I have parents coming in claiming they contain cholesterol. What they conveniently forget is they have the best protein structure there can everbe. So make your child eat eggs."
- Fruit juice is not a replacement for fruit. "Whole fruit is rich in fibre and while its juice may contain vitamins it is also rich in sugar and acids. Fruit juice also works negatively on tooth enamel apart from reducingyour appetite.
If you pack a small carton of fruit juice in your child's lunch box, it is possible he may skip his meal. It is better to put a few pieces of cut fruit in his lunch pack instead."
did you know?
- The two most common nutrients that children lack on average are iron and vitamin D. Iron is an essential part of haemoglobin which carries oxygen in the blood. A lack of it makes children anaemic; symptoms can include a loss of appetite and exhaustion. These symptoms are not just part of anaemia but can be seen in children tired after a long day at school. At the same time, too much iron can affect the liver. So iron supplements should be always taken under a doctor's supervision.
- Theoretically, an overdose of vitamins A D E and K can cause increased brain pressure (BIH), a rare but noticeable side effect. Practically, this is rarely seen. Always treat vitamins as medication, they should be taken only as directed. This is especially true with candy-like tablets that parents often make their kids pop in. They should be kept out of the reach of small children as they may confuse them with sweets. The other rule to follow is to encourage children to maintain oral hygiene. Health supplement candies should be treated like other sticky candies and the mouth should be rinsed and cleaned at all times.
- During processing fruit and vegetable extracts lose out on their nutrients. Often these extracts are given to children assuming they will make up for a lack of fresh fruit and vegetables. But they should be avoided. They cannot make up for the goodness of fresh produce. Also, they lack essential fibre.
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